Early Extubation for Patients With Acute Hypoxemic Respiratory Failure
Mechanical Ventilation, Corona Virus Infection
About this trial
This is an interventional supportive care trial for Mechanical Ventilation focused on measuring helmet interface NIV, early extubation, acute hypoxemic respiratory failure
Eligibility Criteria
Inclusion Criteria:
Age ≥18 years old on mechanical ventilation for at least 48 hours Positive End Expiratory Pressure (PEEP) level between 8 to 13cm H20 The ratio between the partial pressure of oxygen and fraction of inspired oxygen (PaO2/FiO2) between 150 and 300 mmHg with FiO2≤0.6 pH≥7.25 Respiratory rate (RR)≤30/min Adequate gag and cough reflex Ability to spontaneously breathe
Exclusion Criteria:
Hemodynamic instability (Systolic blood pressure <90 or requiring >2 vasoactive agents) Tracheostomy Upper airway obstruction Pregnancy Elevated intracranial pressure Upper airway obstruction Glasgow coma scale ≤ 8 Patients who refuse to undergo endotracheal intubation, whatever the initial therapeutic approach
Sites / Locations
- University of Chicago Medical CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
No Intervention
Helmet non invasive ventilation (NIV)
Control invasive mechanical ventilation
Patients randomized to the intervention group will be extubated to helmet NIV.
Patients randomized to the control group will continue invasive mechanical ventilation. Once weaning criteria are met, patients will undergo a spontaneous breathing trial for 30 minutes. If the spontaneous breathing trial is successful, then the patient will be extubated.